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Though it is recognized that the presence of a mentally handicapped child may be a source of stress for a family, less is known about precisely which impairments are particularly stressful. This question was investigated in a study of 200 families with severely mentally handicapped children living in two health districts in South East England. Interviews were carried out with the people responsible for the day-to-day care of the children and stress was measured by means of the Malaise Inventory. The results suggested that the highest levels of stress were associated with the presence of a child with behaviour disorders or with multiple impairments; the stressfulness of these conditions was exacerbated by adversity. A regression analysis showed that the factors causing most stress in carers were, in order of importance: behaviour problems in the child, night-time disturbance, social isolation, adversity in the family, multiplicity of impairments, difficulty in settling the child at night, problems with the child's health, problems with the child's appearance, and money worries. The article ends with recommendations for the development of services aimed at reducing stress in families with mentally handicapped children.
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